SCIENCE

Cannabis therapy is safe and effective among elderly patients diagnosed with chronic pain, according to clinical data published online ahead of print in the European Journal of Internal Medicine.

Researchers from Hebrew University and the Ben Gurion University of Negrev in Israel assessed the use of therapeutic cannabis over a period of six months in a cohort of 1,186 patients above 65 years of age. The majority of patients enrolled in the trial suffered from pain or cancer. Under an Israeli federal program, over 32,000 citizens are licensed to utilize cannabis therapy.

“After six months of treatment, 93.7 percent of the respondents reported improvement in their condition, and the reported pain level was reduced from a median of 8 on a scale of 0-10 to a median of 4,” researchers reported. The majority of respondents also reported “a significant improvement in [their] overall quality of life.”

Furthermore, over 18 percent of the study’s participants “stopped using opioid analgesics or reduced their dose” – a result that led investigators to conclude, “Cannabis can decrease the use of other prescription medicines, including opioids.” Numerous prior studies, such as those compiled here, similarly show that pain patients typically mitigate or eliminate their opioid use during cannabis therapy.

The adverse effects most commonly reported by participants were dizziness and dry-mouth.

Authors concluded: “The older population is a large and growing part of medical cannabis users. Our study finds that the therapeutic use of cannabis is safe and efficacious in this population.”

Read the abstract of the study, “Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly,” here.

The legalization and regulation of marijuana for adults is associated with a drastic reduction in overall arrests, increased tax revenue, and is not adversely impacting public health or safety, according to a comprehensive report issued by the Drug Policy Alliance.

Among the report’s highlights:

• Marijuana arrests are down. Arrests for marijuana in all legal marijuana states and Washington, D.C. have plummeted, saving states hundreds of millions of dollars and sparing thousands of people from being branded with lifelong criminal records.

• Youth marijuana use is stable. Youth marijuana use rates have remained stable in states that have legalized marijuana for adults age 21 and older.

• Marijuana legalization is linked to lower rates of opioid-related harm. Increased access to legal marijuana has been associated with reductions in some of the most troubling harms associated with opioids, including opioid overdose deaths and untreated opioid use disorders.

• Legalization has not made the roads less safe. DUI arrests are down in Colorado and Washington. The total number of arrests for driving under the influence, of alcohol and other drugs, has declined in Colorado and Washington, the first two states to regulate marijuana for adult use. There is no correlation between marijuana legalization and crash rates. The crash rates in both states are statistically similar to comparable states without legal marijuana laws.

• Marijuana tax revenues are exceeding initial estimates.

• The marijuana industry is creating jobs. Preliminary estimates suggest that the legal marijuana industry employs between 165,000 to 230,000 full and part-time workers across the country.

The full DPA report is available online here. Their findings are similar to prior reviews of the impact of adult use regulatory schemes on health and safety, such as this 2016 CATO Institute report.

NORML has similarly compiled fact-sheets of the most relevant peer-reviewed data addressing the impact of legalization on health, safety, and the economy here.

Long-term exposure to cannabis smoke is not associated with adverse effects on pulmonary function, according to clinical data published in the journal Chronic Obstructive Pulmonary Diseases.

A team of investigators led by researchers at the Colorado School of Public Health assessed the relationship between marijuana use and respiratory function and symptoms in a cohort of 2,300 subjects ages 40 to 80, many of whom also smoked tobacco.

Authors reported, “Neither current nor former marijuana use was associated with increased risk of cough, wheeze, or chronic bronchitis when compared to never marijuana users after adjusting for covariates. … Current and former marijuana smokers had significantly higher FEV1 (forced expiratory volume) … when compared to never users. … Both current and former marijuana use was associated with significantly less quantitative emphysema … when compared to never users, even after adjusting for age, … current tobacco smoking pack years, and BMI. … In agreement with other published studies, we also did not find that marijuana use was associated with more obstructive lung disease.”

The long-term combined use of tobacco and cannabis also was not found to be associated with any additive adverse effects on the lungs. Authors concluded, “Among older adults with a history of tobacco use, marijuana use does not appear to increase risk for adverse lung function. … There may be no to little increased risk of marijuana use for a further increase in respiratory symptoms or adverse effects on lung function among those with a history of concomitant tobacco use.”

Prior longitudinal studies assessing the effects of long-term cannabis smoke exposure on lung function have similarly reported that subjects’ marijuana use history is not positively associated with increased incidences of chronic obstructive pulmonary disease (COPD), lung cancer, or with other significant detrimental effects on pulmonary function.

Full text of the study, “Marijuana use associations with pulmonary symptoms and function in tobacco smokers enrolled in the subpopulations and intermediate outcome measures in COPD Study (SPIROMICS),” appears online here.

Neither the occasional nor the heavy use of marijuana by adolescents is associated with decreased motivation, according to clinical data published online ahead of print in the journal Substance Use & Misuse.

A team of Florida International University researchers assessed the relationship between cannabis use and motivation in 79 adolescent subjects. Participants consisted of both long-term regular consumers and occasional users. Investigators assessed subjects’ motivational tendencies through the use of two validated tools, the Apathy Evaluation Scale and the Motivation and Engagement Scale.

Authors reported: “After controlling for confounds, no significant differences were observed between regular and light users on any motivation index. Similarly, no associations between motivation and lifetime or past 30-day cannabis use amount were observed.”

They concluded, “Our findings do not support a link between reduced motivation and CU among adolescents after controlling for relevant confounds.”

An abstract of the study, “Is cannabis use associated with various indices of motivation among adolescents?”, appears here.

The daily administration of CBD (cannabidiol) as an adjunctive therapy mitigates psychotic symptoms in patients with schizophrenia, according to clinical trial data published online ahead of print in The American Journal of Psychiatry.

British researchers assessed the adjunctive use of CBD compared to placebo over a six-week period in a randomized trial of 88 schizophrenic patients. Participants ingested 1000mg of plant-derived CBD per day.

Subjects in the CBD treatment group “had lower levels of positive psychotic symptoms and were more likely to have been rated as improved and as not severely unwell by the treating clinician” at the conclusion of the trial. CBD administration was also associated with “improvements in cognitive performance and in the level of overall functioning,” although these changes did not reach statistical significance.

“These findings suggest that CBD has beneficial effects in patients with schizophrenia,” authors concluded. “As CBD’s effects do not appear to depend on dopamine receptor antagonism, this agent may represent a new class of treatment for the disorder.”

Results of the prior clinical trial published in the journal Translational Psychiatry determined that CBD is superior to amisulpride, a potent anti-psychotic agent, in mitigating psychotic symptoms in schizophrenic patients.
An abstract of the study, “Cannabidiol (CBD) as an adjunctive therapy in schizophrenia: A multicenter randomized controlled trial,” appears online here.